Hyperhidrosis

Hyperhidrosis: A Doctor’s ViewDiplomat, American Board of Dermatology
Fellow, American Academy of Dermatology
Fellow, American Society of Mohs Surgery
Assistant Clinical Professor of Dermatology, University of California, Irvine

What is hyperhidrosis?Hyperhidrosis is excess sweating. While sweating is a normal human bodily function, some people naturally sweat more or less than others. Some individuals sweat in excess causing problems with school, work and social situations. Hyperhidrosis affects both males and females and can start at any age. It is often a severe and emotionally distressing problem for people with the condition. Effective treatments are now available to help those with hyperhidrosis.How is hyperhidrosis treated?Before botulinum toxin became available for this condition, the list of available treatments was fairly short. Over-the-counter antiperspirants, prescription antiperspirants like Drysol (20% aluminum chloride), iontophoresis, pills like Robinul, and surgery are additional treatments options.How should I use Drysol?Drysol should be applied on dry skin, usually before bedtime. It should NOT be used during the day or when you’ll be sweating because of potential stinging and burning. You should temporarily hold applications of Drysol if your skin becomes overly dry and irritated.

What about pills?Pills (like Robinul) may be reserved for special occasions like school dances, job interviews, weddings, proms, anniversaries, first dates, and other really important events. There are no currently available pills to take daily and there are always potential side effects associated with pills.

What about botulinum toxin (Botox and Myobloc)?The introduction of Botox has nearly revolutionized hyperhidrosis treatment. Very small droplets of the medication are injected directly into the skin with excessive sweating. Areas like the palms, feet, head, face, and underarms are among the commonly treated areas. The treatment is done in the physician’s office and may take from 10-30 minutes to complete. Reduced sweating may be noted in as soon as a few days to 2 weeks after injection. Results are temporary and last approximately 3-12 months. Periodic maintenance re-injection is required.What about Surgery?

Sympathectomy is the specialized, permanent nerve cutting or destruction surgery performed to help decrease some types of sweating. It does not work for all types of excess sweating or for all areas of the body. Consultation with a specialized thoracic surgeon is required. Overall, surgery is usually reserved for severe or resistant cases.How do I treat sweaty feet?
Antiperspirants or deodorants sprayed on the bottom of the feet may be helpful. Absorbent shoe inserts are very helpful for some patients. Women wearing sandals or high heels may benefit from also spraying their soles with a deodorant like Drysol or Certain-Dri before wearing shoes.

Where can I find a specialist?
The Skin Center has physicians who specialize in treatment of this condition and have attended specialty seminars on hyperhidrosis. Call to schedule a consultation visit with our Doctors. We are listed on the physician finder section on www.sweating.org under preffered participating specialists.

Is there a support group?
The International Hyperhidrosis Society or IHHS is the specialty foundation which provides in- depth information for the treatment of excess sweating. IHHS can be contacted at

www.sweatsolutions.org.When should I see a doctor?You should consult a specialist physician like a dermatologist if your sweating is excessive. The definition of “excess” is really individualized and depends on what amount of sweating causes you problems in your life like holding a pen, shaking hands, going on job interviews, or romantic dates. If sweating causes disruptions in your normal life and causes you distress or embarrassment, you should see your physician. Your doctor will want to know how much you sweat and how it affects your daily activities.

What special anti-sweating pearls do you give patients?1. Try Certain-Dri or Drysol first if your sweating isn’t better with regular over the counter products.
2. Robinul pills are a good option for special occasions like prom, job interviews, and weddings.
3. Remember botulinum toxin (Botox or Myobloc) may take 1-2 weeks before you see any results
4. Surgery with a specialized thoracic surgeon may be a last resort because of potential serious risks.

Information in this publication and site is not intended to serve as medical advice. Individuals may use the information as a guide to discuss their treatments with their own physicians. This site does not promote nor endorse the unauthorized practice of medicine by non-physicians or state licensed health care providers.
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